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Home My WebLink About2024-641-E-AMS-Siemens Industry-Increase in costs due to construction delays and add monitoringRevised 04/23 ORANGE COUNTY CHANGE ORDER REQUEST NORTH CAROLINA ______________________________________________________________________________________________________________ Date: 10/16/2024 Project: Efland EMS & ME Review Quarters Change Order No. 03 Department: AMS/ES Department Address: 306 Revere Road, Hillsborough NC 27278 Project: Efland EMS & ME Review Quarters Contractor: Siemens Industry, Inc. Contractor Address: 215 Southport Drive, Ste 900, Morrisville, NC 27560 Effective date of original contract: 05/05/2022 This change order increases decreases the contract time by 437 days. Check here if no impact to contract time . Will this change order impact the date of substantial completion? Yes No. If yes, the amended date of substantial completion is: December 20, 2024 _______________________________________________________________________________________________________________ Full Description of Change: Additional labor hours to cover for delays in construction. Provide monitoring for fire alarm system. Reason for Change: The additional changes are due to the delays in the construction by the General Contractor for this project. The monitoring is required by code for the fire alarm system. _______________________________________________________________________________________________________________ Original contract sum: $ 80,000.00 Contract sum prior to this change order: $ 122,468.28 Amount of this change order: $ 7,400.00 Total sum of the contract including this change order: $ 129,868.28 _______________________________________________________________________________________________________________ This change order is executed to amend the contract time or contract sum. It shall not be construed to impact the original contract, project, services, or work in any other manner. All other terms of the Original Contract remain in effect. Approved and executed this 25th day of October, 2024. _______________________________ _____________________________ _____________________________ Contractor Owner Architect (when retained) By:____________________________ By:___________________________ By:___________________________ Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 Area Geneeral Manager 10/22/2024 10/25/2024 County Manager Revised 04/23 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: Siemens Industry, Inc Vendor Contact Person: Sepesi, Ella (ella.sepesi@siemens.com) Phone: 919.389.4449 Address: 215 Southport Drive, Ste 900 City Morrisville State: NC Zip: 27560 Department: AMS Amount: $7,400.00 Purpose: Increase in costs due to construction delays and add monitoring Budget Code(s): 61750035-880000-17000 Vendor # 53325 Vendor Status with NCSOS: Active Vendor is a BOCC consultant: Yes No Contract Details Contract Type: New Amendment (Original Contract: 05/05/2022) (Most Recent Amendment 03/11/2024) Effective Date 3/18/2024 End Date 12/20/2024 Notice Date (Notice Purpose ) Award Approved by Board (Agenda Date: ); Made or Administered by AMS Signature Authority - BOCC Express Delegation (Agenda Date: ) - Policy 9.4: Under $5,000; Service Under $90,000; Construction Under $250,000 - Budget Policy Section XV (Capital Improvement Project: 17000) Bidding Informal Bidding ($30k-$90k); Formal RFP ($90k+); Other (<$30k); Exception(#l) Department Affirmation This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement. Services related to this agreement have already begun or been completed. Description of the nature of the emergency condition that was addressed: Department Director’s Signature ________________________________________ Date: ________ Information Technologies This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Inapplicable because no hardware/software purchases or related services Risk Management This agreement is approved for sufficiency of insurance standards, specifications, and requirements: Office of the Risk Management Officer___________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Received for record retention: Office of the Clerk to the Board __________________________________________Date:_________ Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 10/22/2024 10/24/2024 10/24/2024 10/24/2024 PROPOSAL EFLAN EMS - Fire Alarm Monitoring PREPARED BY Siemens Industry, Inc. ("Siemens") PREPARED FOR ORANGE COUNTY ASSET MANAGEMENT SERVICES DELIVERED ON September 06, 2024 Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 Table of Contents INTRODUCTION ..............................................................................................................1 Proposal Information .............................................................................................1 Contact Information ..............................................................................................3 CUSTOMER OVERVIEW ....................................................................................................4 Executive Summary ...............................................................................................4 Siemens Capabilities & Customer Commitment ......................................................5 SERVICE SOLUTION .........................................................................................................6 Building Services –Fire ..........................................................................................6 Emergency Response Times – Fire ..........................................................................7 SERVICE IMPLEMENTATION PLAN ....................................................................................8 Connectivity and Communications .........................................................................8 Service Agreement Contract Characteristics............................................................9 General Services ..................................................................................................10 Service Team .......................................................................................................11 TERMS AND CONDITIONS .............................................................................................12 Terms and Conditions ..........................................................................................12 Agreement Terms for Investments .......................................................................13 SIGNATURE PAGE .........................................................................................................14 Signature Page ....................................................................................................14 APPENDICES .................................................................................................................15 Fire & Life Safety..................................................................................................15 Page 2 of 15 Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 Proposal #:9154690 Date:September 06, 2024 Contact Information Sales Executive:Nelson Ciuffardi Branch Address:215 Southport Dr. Suite 900 Morrisville, NC,27560 Telephone:984.389.5833 Email Address:nelson.ciuffardi@siemens.com Customer Contact:Angel Barnes Customer:ORANGE COUNTY ASSET MANAGEMENT SERVICES Address:600 NC HIGHWAY 86 N HILLSBOROUGH, North Carolina 27278-8225 United States of America Services shall be provided at:EFLAN EMS Page 3 of 15 Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 Executive Summary Customer Needs The Services proposed in this agreement are specifically designed for ORANGE COUNTY ASSET MANAGEMENT SERVICES, and the services provided herein will help you in achieving your facility goals. Services Included Siemens will provide the following services. Service Description •Alarm Management Services - Fire Page 4 of 15 Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 Siemens Capabilities & Customer Commitment Siemens Industry, Inc. is a leading single-source provider of cost-effective facility performance solutions for the comfort, life safety, security, energy efficiency and operation of some of the most technically advanced buildings in the world. For more than 150 years, Siemens has built a culture of long-term commitment to customers through innovation and technology. Siemens is a financially strong global organization with a Branch network that delivers personalized service and support to customers in multiple industries and locations. References are available upon request. Page 5 of 15 Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 Building Services –Fire Services that deliver the outcomes you want to achieve. Services delivered by Siemens have been developed to help you achieve the outcomes you expect. Fire Safety industry acronyms used in the following service descriptions: AHJ – Authority Having Jurisdiction NFPA – National Fire Protection Association Optimize Performance & Productivity Alarm Management Services – Fire Siemens will coordinate and administer off-site monitoring of your fire alarm and life safety system via Siemens or a third-party UL Listed Central Monitoring Station. The fire procedures used in monitoring are in accordance with NFPA 72 and local authorities and can only be altered in writing by the Authority Having Jurisdiction. Daily system tests are standard in fire monitoring to ensure the communication path is operational. All low priority signals to be sent via text/email. Page 6 of 15 Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 Emergency Response Times – Fire Emergency Online/Phone Response Billable Service Online system and software troubleshooting and diagnostics and phone support will not be provided under the coverage of this agreement. Siemens will respond to your request for emergency on-line/phone support, Mon-Fri 8:00AM-5:00PM, excluding holidays, upon receiving notification of an emergency, as determined by your staff and Siemens, but all service performed will be provided as a billable service. If remote diagnostics determine a site visit is required to resolve the problem, a technician can be dispatched. Depending on your contract coverage, the on-site dispatch will be covered or will be a billable service call. Emergency On-site Response Billable Service Emergency Onsite Response is not included within the coverage of this agreement. Siemens will respond to your request for emergency on-site service as soon as staff is available. An emergency is determined by your staff and Siemens. All service performed will be provided as a billable service.Siemens will respond to your request for emergency onsite support, Mon-Fri 8:00AM-5:00PM, excluding holidays, upon receiving notification of an emergency, as determined by your staff and Siemens, but all service performed will be provided as a billable service. Page 7 of 15 Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 Connectivity and Communications Siemens Service Portal The Service Portal complements the personalized services you will receive from your local Siemens office by providing greater visibility into equipment and services delivered by Siemens. This web-based portal allows you the ability to submit service requests, confirm and modify schedules,track repairs, manage agreements, generate reports, and access critical information; then share it across your entire enterprise quickly and efficiently.The Service Portal is a user-friendly way to increase your productivity and the value of your service program. Data security as a basic requirement We value confidentiality and long-term partnerships. That is why we give the security of your data the highest priority. Before we implement an enhanced service package with remote support, we conduct an in- depth analysis of the situation, taking into account national and international regulations, technical infrastructures and industry specifics. Our service employees carefully evaluate your needs on an individual basis with a view toward information security. Page 8 of 15 Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 Service Agreement Contract Characteristics Description FIRE Hours of Coverage Mon-Fri, 8:00 AM - 5:00 PM Response Times (Phone/Online)Billable Response Times (Onsite/Emergency)Billable Remote Services Yes Third Party Systems No Monitoring Yes Additional Labor Discount 20.0% Additional Material Discount 0.0% Labor and material discounts are applicable for sites identified in this agreement and are only available for the disciplines included in this agreement.Material discounts do not apply to 3rd party or non-Siemens Building Products manufactured components. Page 9 of 15 Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 General Services Fire Service Description Qty Frequency Year Alarm Management Services - Fire 1 12 1,2,3,4,5 Page 10 of 15 Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 Sales Executive manages the overall strategic service plan based upon your current and future service requirements. Client Services Manager is responsible for ensuring that our contractual obligations are delivered, your expectations are being met and you are satisfied with the delivery of our services. Primary Service Specialist is responsible for performing the ongoing service of your system. Secondary Service Specialist who will be familiarized with your building systems to provide in-depth backup coverage. Remote Services Specialist is responsible for the execution of remote services including proactive planned tasks, in-depth fault analysis and identification of corrective actions. Service Operations Manager is responsible for managing the delivery of your entire support program and service requirements. Service Coordinator is responsible for scheduling your planned maintenance visits, and handling your emergency situations by taking the appropriate action. Service Administrator is responsible for all service invoicing including both service agreement and service projects. Service Team An important benefit of your Service Agreement derives from having the trained building service personnel of Siemens Industry, Inc. familiar with your building systems.Our implementation team of local experts provides thorough, reliable service and scheduling for the support of your system. Added to the team is a team of building experts at our Digital Service Center. The benefits you receive are less disruption to your employees at the site, less intrusive on the system at peak hours, fewer emissions for trucks rolled, and real time analytics with digital workspace hours. The following list outlines the service team that will be assigned to the service agreement for your facility Your Assigned Team of Service Professionals will include: Page 11 of 15 Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 Terms and Conditions Terms and Conditions (Click to download) Terms & Conditions (www.siemens.com/standard-terms-service) Price Escalation.If, during the term of this Contract, the price of various materials or labor or logistics are increased as reflected by CRU, CMAI, COMEX market indexes or IHS Markit, then Siemens may increase the applicable yearly Investment or apply a surcharge accordingly. As a result of the global Covid-19 Virus outbreak, temporary delays in delivery, labor or services from Siemens and its sub-suppliers or subcontractors may occur. Among other factors, Siemens' delivery is subject to the correct and punctual supply from sub-suppliers or subcontractors, and Siemens reserves the right to make partial deliveries or modify its labor or services. While Siemens shall make every commercially reasonable effort to meet the delivery or service or completion date mentioned above, such date is subject to change. To the extent applicable, the following Addendum(s) are incorporated and made part of the Siemens Standard Terms and Conditions: Click on addendum below to read/download Monitoring (www.siemens.com/monitoring-addendum) Fire Life Safety (www.siemens.com/fls-addendum) Exclusions and Clarifications (www.siemens.com/clarification-addendum) Page 12 of 15 Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 Agreement Terms for Investments Services shall be provided at: , Siemens Industry, Inc. shall provide the services as identified in this Proposal and pursuant to the associated terms and conditions contained within. Duration (Initial Term and Renewal): This Agreement shall remain in effect for an Initial Term of 5 Periods beginning October 1, 2024. After the expiration of the Initial Term, this Agreement shall automatically renew for successive one year periods.The Investments for each year after the Initial Term of the Agreement and each year of each renewal of this Agreement shall be determined as the immediate prior year's Investment plus an escalator of 5.5%or as allowed per this proposal.In addition, each renewal term pricing shall be adjusted for any additions or deletions to services selected for the renewal term. Initial Term Investments: Period Period Range Billing Frequency Annual Price 1 Oct 1,2024 - Sep 30,2025 Annually (In Advance)$1,080.00 2 Oct 1,2025 - Sep 30,2026 Annually (In Advance)$1,080.00 3 Oct 1,2026 - Sep 30,2027 Annually (In Advance)$1,080.00 4 Oct 1,2027 - Sep 30,2028 Annually (In Advance)$1,080.00 5 Oct 1,2028 - Sep 30,2029 Annually (In Advance)$1,080.00 Multi-Period Investment Total $5,400.00 Amount Due In Advance Based On Billing Frequency Applicable sales taxes are excluded from the Investments.The pricing quoted in this Proposal is firm for 30 days. Siemens Industry, Inc. invoices paid by credit card may be subject to a surcharge of up to 2%. Page 13 of 15 Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 Signature Page The Buyer acknowledges that when accepted by the Buyer as proposed by Siemens Industry, Inc., this Proposal and the Standard Terms and Conditions of Sale for Services, (together with any other documents, including any applicable Rider(s), incorporated herein) shall constitute the entire agreement of the parties with respect to its subject matter. BY EXECUTION HEREOF, THE SIGNER CERTIFIES THAT (S)HE HAS READ ALL OF THE TERMS AND CONDITIONS AND DOCUMENTS, THAT SIEMENS INDUSTRY, INC. OR ITS REPRESENTATIVES HAVE MADE NO AGREEMENTS OR REPRESENTATIONS EXCEPT AS SET FORTH THEREIN, AND THAT (S)HE IS DULY AUTHORIZED TO EXECUTE THE SIGNATURE PAGE ON BEHALF OF THE BUYER. Initial Term Investments Period Period Range Billing Frequency Annual Price 1 Oct 1,2024 - Sep 30,2025 Annually (In Advance)$1,080.00 2 Oct 1,2025 - Sep 30,2026 Annually (In Advance)$1,080.00 3 Oct 1,2026 - Sep 30,2027 Annually (In Advance)$1,080.00 4 Oct 1,2027 - Sep 30,2028 Annually (In Advance)$1,080.00 5 Oct 1,2028 - Sep 30,2029 Annually (In Advance)$1,080.00 Proposed by:Accepted by: Siemens Industry, Inc. ______________________________________ Company ORANGE COUNTY ASSET MANAGEMENT SERVICES _____________________________________ Company Nelson Ciuffardi ______________________________________ Name _____________________________________ Name (Printed) 9154690 ______________________________________ Proposal # _____________________________________ Signature $5,400.00 ______________________________________ Proposal Amount _____________________________________ Title September 06, 2024 ______________________________________ Date _____________________________________ Date _____________________________________ Purchase Order #⬜PO for billing/pmnt only ⬜PO not required Page 14 of 15 Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 Fire & Life Safety Page 15 of 15 Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY B 10/01/2024 N/A 4433 of Marsh USA LLC X RENTA C N/A 10,000,000 UB-8P79233A-24-51-R (AZ,MA,WI) 41343 A 10/01/2025 X Travelers Casualty & Surety Company CN102147003-RAM--24/25 1,000,000 25674 ... NYC-009196547-33 10/01/2024 X INCL 10/16/2024 10/01/2025 '''''''''''$500K LIMIT / $500K SIR''''''''''' 10 N/A 10/01/2025 NOC60 1,000,000 X 1,000,000 1,000,000 B 10/01/2025 10/01/2024 19038 TC2J-CAP-7440L34A-TIL-24 100,000 10/01/2024 UB-8P83929A-24-51-K (AOS) TWXJUB-7440L338-TIL-24 (OH) X 1,000,000 SEE ATTACHED RE: JOB NO. N/A 1000 DEERFIELD PARKWAY SIEMENS INDUSTRY, INC. BUFFALO GROVE, IL 60089-4513 1,000,000 HDI Global Insurance Company X 445 SOUTH STREET MARSH USA, LLC. MORRISTOWN, NJ 07960-6454 GLD1110116 Travelers Property Casualty Co. of America N PO BOX 8181 HILLSBOROUGH, NC 27278 ORANGE COUNTY ATTN: RISK MANAGEMENT 10/01/2024 B 2,000,000 X X 10/01/2025 Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: MARSH USA, LLC. �� EXTENT THAT A CLAIM ARISES FROM THE NEGLIGENCE OF SIEMENS INDUSTRY, INC. OR ITS SUBCONTRACTORS WITH RESPECT TO ALL OPERATIONS OF THE CONTRIBUTORY INSURANCE TO THE�� ORANGE COUNTY, ITS OFFICERS, OFFICIAL AGENTS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED UNDER THE ABOVE REFERENCED GENERAL �� LIABILITY INSURANCE POLICIES AND THE COVERAGE AFFORDED THE ADDITIONAL INSURED UNDER THESE POLICIES SHALL BE PRIMARY AND NON- LIABILITY AND AUTOMOBILE�� WAIVER OF SUBROGATION IS EFFECTUAL WHERE REQUIRED BY WRITTEN CONTRACT. �� INSURED BUT ONLY WITH�� 2 Morristown Certificate of Liability Insurance �� IF THESE POLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NON-PAYMENT OF PREMIUM, THE INSURER WILL DELIVER NOTICE OF CANCELLATION TO �� RESPECT TO ALL WORK PERFORMED BY AND ON BEHALF OF THE NAMED INSURED, SIEMENS INDUSTRY, INC. FOR CERTIFICATE HOLDER UNDER CONTRACT. �� THE CERTIFICATE HOLDER UP�� 25 �� RE: JOB NO. N/A�� UMBRELLA IS FOLLOW FORM OF PRIMARY SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSIONS. �� 1000 DEERFIELD PARKWAY��SIEMENS INDUSTRY, INC.�� BUFFALO GROVE,IL 60089-4513�� TO 60 DAYS PRIOR TO THE CANCELLATION OR AS REQUIRED BY WRITTEN CONTRACT, WHICHEVER IS LESS. �� 2 CN102147003 �� Docusign Envelope ID: 41FDB6BA-25A5-4679-92AC-3AB198A89E13